经鼻高流量氧疗不同流速对慢性阻塞性肺疾病患者的影响OA

Objective:To investigate the impact of different flow rates of high-flow nasal cannula(HFNC)on diaphragmatic function,subjective comfort,respiratory distress,and arterial blood gas parameters in patients with chronic obstructive pulmonary disease(COPD).Method:Ninety COPD patients admitted to the First Affiliated Hospital of Bengbu Medical University from December 2023 to June 2024 were enrolled and randomly assigned to either a low-flow rate group(30 L/min)and a high-flow rate group(60 L/min),with 45 patients in each group.Diaphragmatic excursion during quiet breathing(DEq)and diaphragmatic rapid shallow breathing index(D-RSBI)were assessed using bedside ultrasound before treatment and at 2,8 and 24 hours after intervention.Simultaneously,comfort level,degree of respiratory distress,and arterial blood gas values of patients were recorded.Result:No significant differences were observed between groups before treatment in DEq,D-RSBI,comfort level,degree of respiratory distress,PaO2,and PaCO2(P>0.05).At 2,8,24 h after treatment,the DEq and D-RSBI values of the high-flow rate group were lower than those of the low-flow rate group(P<0.05);at 2,8,24 h after treatment,the comfort level,and degree of respiratory distress of the low-flow rate group were better than those of the high-flow rate group(P<0.05).At 2,8,24 h after treatment,PaO2 and PaCO2 values did not differ significantly between the two groups(P>0.05).Conclusion:HFNC at different flow rates significantly influences diaphragmatic function,physiological parameters,and patient-perceived comfort in COPD patients.To maximize therapeutic benefit,individualized oxygen therapy should strive to balance physiological efficacy with patient comfort.